Eating Disorders
What is an eating
disorder?
Eating disorders are considered a mental disorder defi ned by
abnormal eating behaviors that adversely aff ect a person’s
physical or mental health. They are serious, often times life-
threatening mental illnesses that can aff ect anyone, regardless
of age, race, gender identity, sexual orientation, or background.
What is the
Eating disorders have the second highest mortality rate of any
importance?
psychiatric illness behind opiate addiction. Individuals with
eating disorders are at higher risk for medical complications
and suicide. Early detection and treatment are important for
full physical and emotional recovery.
Etiology of Eating
The exact cause of eating disorders is unknown; however, there are several
Disorders
factors associated with a higher risk of being diagnosed with an eating
disorder.
Psychological
Biological Factors Social Factors
Factors
• Genetic • Being a
predisposition perfectionist
• Family history of • Other mental • Desiring the
eating disorders disorders “ideal” body type
or other mental • Refusing or being • Weight
illnesses unable to move stigma/diet
• History of back and forth culture
dieting between tasks • Bullying/teasing
• Chronic medical • Being dissatisfied • Trauma history
conditions such with one’s body
as TIDM image
Types of Eating
Disorders
ANOREXIA NERVOSA (DSM-IV-TR 307.1) IS CHARACTERIZED BY EMACIATION, A RELENTLESS
PURSUIT OF THINNESS AND UNWILLINGNESS TO MAINTAIN A NORMAL OR HEALTHY WEIGHT, A
DISTORTION OF BODY IMAGE AND INTENSE FEAR OF GAINING WEIGHT. ANOREXIA WITHOUT
SIGNIFICANTLY LOW BODY WEIGHT IS CLASSIFIED AS ATYPICAL ANOREXIA.
BULIMIA NERVOSA (DSM-IV 307.51 ) IS CHARACTERIZED BY RECURRENT AND FREQUENT
EPISODES OF EATING UNUSUALLY LARGE AMOUNTS OF FOOD AND FEELING A LACK OF
CONTROL OVER THE EATING. THIS BINGE-EATING IS FOLLOWED BY A TYPE OF BEHAVIOR THAT
COMPENSATES FOR THE BINGE, SUCH AS PURGING, FASTING AND/OR EXCESSIVE EXERCISE.
BINGE EATING DISORDER (DSM-IV 307.50) IS THE RECURRING EPISODES OF EATING
SIGNIFICANTLY MORE FOOD IN A SHORT PERIOD OF TIME THAN MOST PEOPLE WOULD EAT UNDER
SIMILAR CIRCUMSTANCES, WITH EPISODES ACCOMPANIED BY FEELINGS OF LACK OF CONTROL.
OTHER SPECIFIED FEEDING OR EATING DISORDER (OSFED) OCCURS WHEN SOMEONE MEETS
SOME BUT NOT ALL OF THE CRITERIA FOR AN EATING DISORDER. EXAMPLES ARE ATYPICAL
ANOREXIA, BINGE EATING DISORDER AND/OR BULIMIA NERVOSA EPISODES THAT ARE LESS
FREQUENT, PURGING DISORDER WITHOUT BINGING, AND NIGHT EATING SYNDROME WHERE A
PERSON CONSUMES AT LEAST 25% OF DAILY INTAKE IN THE EVENING
Types of Eating
Disorders
AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER (ARFID) IS A DISTURBANCE THAT
KEEPS PEOPLE FROM MEETING THEIR NUTRITIONAL NEEDS SUCH AS DIFFICULTY
CHEWING/SWALLOWING, FEAR OF VOMITING, OR AVOIDING CERTAIN FOOD TEXTURES.
BODY DYSMORPHIC DISORDER (BDD) IS AN OBSESSION WITH AN IMAGINARY DEFECT IN
PHYSICAL APPEARANCE OR AN EXTREME CONCERN WITH A SLIGHT PHYSICAL BLEMISH,
WHICH OTHERS MAY NOT EVEN SEE.
PICA INVOLVES EATING SUBSTANCES THAT HAVE NO NUTRITIONAL VALUE FOR AT LEAST ONE
MONTH. SOMEONE STRUGGLING WITH PICA MIGHT EAT A SUBSTANCE LIKE ICE, CLAY, SOIL OR
PAPER.
RUMINATION DISORDER IS A CONDITION WHERE A PERSON SPITS UP FOOD FROM
THE STOMACH, RECHEWS IT, AND EITHER SWALLOWS IT AGAIN OR SPITS IT OUT. IT
USUALLY OCCURS WITHIN 30 MINUTES OF EVERY MEAL
ANOREXIA
According to the DSM-IV, a diagnosisNERVOSA
of anorexia nervosa requires the presence of four key
criteria:
1.Weight Maintenance: The individual refuses to maintain body weight above a minimal
normal level for age and height, or fails to gain expected weight during growth, resulting in a
body weight at least 15% below expected. A body weight of less than 85% of that expected
for age, height, and sex.
2.Intense Fear: There is an intense fear of gaining weight or becoming fat, even when
underweight.
3.Body Image Disturbance: The person experiences a disturbance in how their body weight,
size, or shape is perceived, with undue influence of these factors on self-evaluation, or denial
of the seriousness of their low weight.
4.Amenorrhea: In postmenarchal females, the absence of at least three consecutive
menstrual cycles must be present.
Subtypes:
5.Restricting Type: Accomplish weight loss through dieting, fasting or excessive exercise
6.Binge-eating/purging type: Engage in regular binge eating and/or purging
Physical Findings
1 Cold intolerance 6 Face Fullness
2 Reduced Gastric 7 Bluish tint fingers and
Emptying toes
Abnormal vital signs
3 Constipation 8 and lab values
4 Lanugo
9 Reduced bone mineral
density
5 Alopecia
Bulimia Nervosa
According to the DSM-IV, a diagnosis of bulimia nervosa requires the following criteria:
1.Recurrent Episodes of Binge Eating: Involves eating an excessive amount of food in a discrete
period, accompanied by a sense of loss of control during the episode.
2.Inappropriate Compensatory Behaviors: To prevent weight gain, individuals engage in behaviors
such as self-induced vomiting, misuse of laxatives, fasting, or excessive exercise.
3.Frequency: The binge eating and compensatory behaviors occur, on average, at least once a week for
three months.
4.Self-Evaluation: The individual’s self-worth is excessively influenced by body shape and weight.
5.Exclusion of Anorexia Nervosa: The behaviors do not occur exclusively during episodes of anorexia
nervosa.
Subtypes:
6. Purging: Regularly engaging in self-induced vomiting, misuse of laxatives, diuretics or enemas
7. Non-purging: Uses abnormal compensatory weight loss behavior such as fasting and excessive
exercising
Health
1 Consequences
6
Russell’s Sign: markings Mallory-Weiss tears: tear in
on knuckles or backs of the tissue of the lower
hands esophagus
2 Face Fullness or 7 Fluid Imbalances
“Chipmunk Cheeks”
3 Teeth Enamel 8 Electrolyte Imbalances
Erosion
4 Esophagitis
9 Syrup of ipecac -
cardiotoxic
5 GERD
BINGE EATING
DISORDER
According to the DSM-IV, a diagnosis of binge eating disorder (BED) requires the following criteria:
1.Recurrent Episodes of Binge Eating: Characterized by consuming an unusually large amount
of food in a short period, accompanied by a sense of loss of control during the episode.
2.Binge Eating Symptoms: At least three of the following must be present:
⚬ Eating much more rapidly than normal.
⚬ Eating until feeling uncomfortably full.
⚬ Eating large amounts of food when not physically hungry.
⚬ Eating alone due to embarrassment about the quantity of food consumed.
⚬ Feeling disgusted, depressed, or guilty after overeating.
3.Frequency: The binge eating episodes occur, on average, at least once a week for three
months.
4.Distress: The binge eating causes significant distress and impairment in social, occupational,
or other areas of functioning.
5.Exclusion of Other Disorders: The episodes do not occur exclusively during the course of
bulimia nervosa or anorexia nervosa.
Role of a dietitian in
Nutrition Therapy
Initially asses the patient’s nutritional status
Address patient’s food & nutrition issues & the behaviors
associated with those issues
Monitor the patient’s response to treatment
Communicate & support the eff orts of the other
interdisciplinary team members as is appropriate
26% of people
struggling with
Every 52 eating disorders
minutes
attempt suicide
someone dies
Less than 6% are medically underweight
from an eating
28.8 million people in America struggle
disorder with eating disorders
22% of children and adolescents
worldwide show disordered eating
Nutrition therapy
Nutrition therapy for eating disorders is a specialized approach that focuses on helping individuals restore healthy eating patterns and
improve their relationship with food. It plays a crucial role in the treatment of various eating disorders, including anorexia nervosa,
bulimia nervosa, and binge eating disorder. Here are some key aspects:
1. Assessment and Individualization
Comprehensive Evaluation: A registered dietitian assesses dietary habits, medical history, and psychological factors.
Tailored Plans: Individualized meal plans are created to meet nutritional needs and address specific behaviors related to the eating disorder.
2. Nutritional Education
Understanding Nutrition: Clients learn about macronutrients, micronutrients, and the role of food in overall health.
Food Groups and Portions: Education on balanced meals and appropriate portion sizes helps demystify food choices.
3. Structured Eating
Regular Meal and Snack Times: Establishing a routine helps normalize eating patterns and reduces anxiety around food.
Mindful Eating Practices: Encouraging clients to pay attention to hunger and fullness cues promotes a healthier relationship with food.
4. Addressing Psychological Aspects
Coping Strategies: Teaching skills to manage triggers and emotions that may lead to disordered eating behaviors.
Behavior Modification: Working on changing harmful eating patterns and beliefs about food and body image.
5. Collaboration with Mental Health Professionals
Integrated Care: Nutrition therapy is often part of a multidisciplinary approach that includes therapy and medical support to address the psychological aspects of
eating disorders.
6. Ongoing Support and Monitoring
Regular Check-Ins: Continuous support helps track progress, address challenges, and adjust meal plans as needed.
Nutrition Therapy Goals
Anorexia Nervosa
• Recommended weight gain
• 2 to 3 pounds per week/inpatient
• 0.5 to 1 pound per week outpatient
• Initial energy intake 30 to 40 kcal/kg of
body weight per day
• Active phase of weight gain 70 to 100
kcal/kg
• Weight maintenancee 40 to 60 kcal/kg
• Ensure adequate intake of Vitamin D
&Ca+
Nutrition Therapy Goals
Bulimia Nervosa
• Reduce cycle of binging & purging and to normalize patient’s
eating habits
• Structured eating – 3 meals per day plus 1 to 3 snacks
• Help patient to expand diet to include forbidden or feared
foods
Nutrition Therapy
bINGE eATING
Goals
dISORDER
• Encouraging regular meal and snack times to prevent
extreme hunger and reduce the likelihood of binge
episodes.
• Teaching clients to listen to their bodies and
recognize true hunger versus emotional or situational
triggers.
• Encouraging slower eating, savoring fl avors, and
paying attention to portion sizes to enhance the
eating experience.
• Helping clients recognize emotional or environmental
triggers that lead to binge eating episodes.
Talk to Someone
You Trust
National Eating Disorder Association
https://www.nationaleatingdisorders.org/get-help/
National Eating Disorder Information Center
https://nedic.ca/
Eating Recovery Center
https://www.eatingrecoverycenter.com/resources/eating-disorder-
statistics
Start your happiness
from within
References
1.ANAD. (2024). Eating Disorder Types and Symptoms. National Association of Anorexia Nervosa and Associated Disorders. https://anad.org/eating-
disorder-types-and-symptoms/
2.Bunnell, D. (n.d.). Statistics. National Eating Disorders Association. https://www.nationaleatingdisorders.org/statistics/
3.National Eating Disorders Association. (n.d.). Eating Disorders 101. https://www.nationaleatingdisorders.org/wp-content/uploads/2024/04/Eating-
Disorders-101.pdf
4. https://nedic.ca/
5.https://www.eatingdisorderhope.com/long-term-effects-health
